View source for Harbor:EKG STEMI Screening

==General Rules==
*R4s, in addition to attendings can screen for ECGs to ensure a timely screen for STEMI. The point of this screen is to pick up STEMIs as soon as possible. If you see any other emergent issues on the EKG, feel free to call the responsible provider, but it's not the screener's job to relate all EKG issues to the responsible physician.
*Please do not refuse EKGs from the EKG tech if you are an attending or R4 no matter what you are doing (including rounds). It takes only seconds to look at the EKG for a STEMI. Computer entry can be done later if necessary.

==Process==

*ECGs being done in AED rooms would be given to the R4 or attending in the AED/Purple physician workroom, similarly ECGs done in the RME area would be given to the R4/attending in the RME/Green physician work room. IT DOESN'T HAVE TO BE YOUR PATIENT.

*If the ECG tech is unable to locate the R4 or attending, then they should call the ED attending Spectralink phones (Purple/AED 23202, and Green/RME 23206) to find their location and bring them the ECG. (Even if rounding or seeing a patient).

*If a STEMI is identified, or if there are any questions about a possible STEMI, the R4 should confirm with an ED attending prior to activating a STEMI. 

*ECG techs should not be batch handing the ECGs to the R4/Attending in order to prevent any unnecessary delays. 

*Of note: there is not always an R4 working each shift, so it's important for the ECG tech to ask who is interpreting ECGs on any given shift. We will ensure that the physician appropriately identifies themselves and are receptive to this plan prior to implementation. 

*R4s and attendings will click on the ECG in ORCHID, and perform the ED Screen: Document "NO STEMI” or "STEMI ACTIVATION PERFORMED" on the EKG interpretation and click on the "ED Review" button to clear the eyeglasses icon . The time of the entry is stamped on the EKG read.

*For patients already admitted or officially on OBS/CORE - perform the screen but do not enter an interpretation or clear the eyeglasses, so the responsible physicians know that they have a EKG waiting. If there's a STEMI or other concerning finding NOTIFY THE RESPONSIBLE TEAM.

*Should you not have immediate access to enter your interpretation on the computer (sometimes the EKG has not been uploaded, or you are occupied and/or not near a computer), write the interpretation time on the EKG and save it. Then when you have time, go back and do the entry but now add the time "NO STEMI ACTIVATION READ AT [TIME]"

==See Also==
*[[Harbor:Operations manual]]
*[[Harbor:Code STEMI]]

==References==
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[[Category:Admin]]